<!DOCTYPE html>
<html xmlns:th="http://www.thymeleaf.org">
<head>
    <meta charset="utf-8">
    <title>订单状态编辑</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width, initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=0">
    <link rel="stylesheet" href="/layui/css/layui.css" media="all">
</head>
<body>

<div class="layui-form" lay-filter="layuiadmin-form-admin" id="layuiadmin-form-admin" style="padding: 20px 30px 0 0;">
    <div class="layui-form-item">
        <label class="layui-form-label">订单编号：</label>
        <label class="layui-form-label layui-gray" style="text-align:left; padding-left:0px;">111111111</label>
    </div>
	<div class="layui-form-item">
    <label class="layui-form-label">选择商品：</label>
    <div class="layui-input-inline" style="width:150px;">
      <select name="orderStatus" id="orderStatus"  lay-verify="required" lay-filter="select1">
                                    <option selected="selected" value="703">商品名称2（6瓶）</option>
                                    <option value="701">商品名称4（6瓶）</option>
                                </select>
    </div>
    <div class="layui-input-inline" style="width:50px;">
      <input type="text" name="userName" id="userName" autocomplete="off" class="layui-input" value="1">
    </div>
    <div class="layui-input-inline" style="width:100px;">
      <button class="layui-btn layuiadmin-btn-admin" data-type="add" onclick="Add();" >添加</button>
    </div>
  </div>
  <div class="layui-form-item">
        <label class="layui-form-label">提货商品：</label>
        <label class="layui-form-label layui-gray" style="text-align:left; padding-left:0px;width:300px;">商品名称2（6瓶）;商品名称4（6瓶）</label>
    </div>
	<div class="layui-form-item">
        <label class="layui-form-label">物流类型：</label>
        <div class="layui-input-inline">
                                <select name="orderStatus" id="orderStatus"  lay-verify="required" lay-filter="select1">
                                    <option selected="selected" value="703">快递</option>
                                    <option value="701">公司自提</option>
                                    <option value="702">到店自提</option>
                                </select>
        </div>
    </div>
	<div class="layui-form-item kd1" style="background-color:#333;">
        <label class="layui-form-label">自提店名：</label>
        <div class="layui-input-inline" style="width:320px;">
            <input type="text" name="userName" id="userName" autocomplete="off" class="layui-input" value="自提店名">
        </div>
    </div>
	<div class="layui-form-item kd1">
        <label class="layui-form-label">联系姓名：</label>
        <div class="layui-input-inline" style="width:320px;">
            <input type="text" name="userName" id="userName" autocomplete="off" class="layui-input" value="姓名">
        </div>
    </div>
	<div class="layui-form-item kd1">
        <label class="layui-form-label">联系电话：</label>
        <div class="layui-input-inline" style="width:320px;">
            <input type="text" name="phone" id="phone" autocomplete="off" class="layui-input" value="18566662222">
        </div>
    </div>
	<div class="layui-form-item kd1">
    <label class="layui-form-label">联系地址：</label>
    <div class="layui-input-inline" style="width:100px;">
      <select name="quiz1">
        <option value="">贵州省</option>
      </select>
    </div>
    <div class="layui-input-inline" style="width:100px;">
      <select name="quiz2">
        <option value="">贵阳市</option>
      </select>
    </div>
    <div class="layui-input-inline" style="width:100px;">
      <select name="quiz3">
        <option value="">小河区</option>
      </select>
    </div>
  </div>
	<div class="layui-form-item kd1">
        <label class="layui-form-label">详细地址：</label>
        <div class="layui-input-inline" style="width:320px;">
            <input type="text" name="detail_addr" id="detail_addr" autocomplete="off" class="layui-input" value="详细地址">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">修改备注：</label>
        <div class="layui-input-inline" style="width:320px;">
            <textarea id="note" name="note" placeholder="请输入内容" class="layui-textarea"></textarea>
        </div>
    </div>
    <div class="layui-form-item layui-hide">
        <input type="button" lay-submit lay-filter="LAY-user-front-submit" id="LAY-user-back-submit" value="确认">
    </div>
</div>

<script src="/layui/layui.js"></script>
<script>
    layui.config({
        base: '/' //静态资源所在路径
    }).extend({
        index: 'lib/index' //主入口模块
    }).use(['index', 'form'], function(){
        var $ = layui.$
            ,form = layui.form ;
    })
</script>
</body>
</html>